JP2012101035A - Staple formed over wire wound closure procedure - Google Patents

Staple formed over wire wound closure procedure Download PDF

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JP2012101035A
JP2012101035A JP2011191645A JP2011191645A JP2012101035A JP 2012101035 A JP2012101035 A JP 2012101035A JP 2011191645 A JP2011191645 A JP 2011191645A JP 2011191645 A JP2011191645 A JP 2011191645A JP 2012101035 A JP2012101035 A JP 2012101035A
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staple
longitudinal axis
leg
anvil
folding pocket
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Stanislaw Kostrezewski
コスツルゼウスキー スタニスロウ
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Covidien LP
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Tyco Healthcare Group LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07292—Reinforcements for staple line, e.g. pledgets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A61B17/0686—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying below the tissue during stapling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

PROBLEM TO BE SOLVED: To provide a staple formed over the wire wound closure procedure.SOLUTION: An anvil assembly 12 for use with a surgical stapling instrument 10 includes an anvil member having a longitudinal shaft, a first staple bending pocket, and a second staple bending pocket, and a reinforcing material extended over the first staple bending pocket and the second staple bending pocket. The width of the reinforcing material is narrower than that of the first and second staple bending pockets.

Description

（１．技術分野）
本開示は、外科手術用器具、および創傷閉鎖処置中に組織を留めるための、構造的コンポーネントの上にステープルを形成する方法である。さらに詳細には、本開示は、留めワイヤと、創傷閉鎖処置中に組織を固定するために留めワイヤの周りにステープルの組織貫通端を形成するように構成されるステープルポケットとを組み込むアンビルアセンブリに関する。 (1. Technical field)
The present disclosure is a surgical instrument and method for forming staples on a structural component for securing tissue during a wound closure procedure. More particularly, the present disclosure relates to an anvil assembly that incorporates a retaining wire and a staple pocket configured to form a tissue penetrating end of the staple around the retaining wire to secure tissue during a wound closure procedure. .

（２．関連技術の背景）
外科手術用ステープル留めデバイスは、身体組織の区分を繋ぎ合わす目的で身体組織に１列以上のファスナー（例えば、ステープルまたは２部式ファスナー）を連続的または同時に適用するために外科医により使用される。このようなデバイスは、概して、１組の顎または指状構造を含み、繋ぎ合わされる身体組織はこの間に配置される。ステープル留めデバイスが起動（または発射）されるとき、長手方向に動く発射棒は、一方の顎にあるステープル駆動部材に接触する。ステープル駆動部材は、身体組織を通して、ステープルをクリンプする反対側の顎のアンビルに外科手術用ステープルを押し入れる。組織が、除去または分離される場合、ナイフの刃が、複数の線のステープルの間の組織を切るためにデバイスの顎に提供され得る。 (2. Background of related technology)
Surgical stapling devices are used by surgeons to apply one or more rows of fasteners (eg, staples or two-part fasteners) to body tissue sequentially or simultaneously for the purpose of joining sections of body tissue. Such devices generally include a set of jaws or finger-like structures with the body tissue to be joined disposed therebetween. When the stapling device is activated (or fired), the longitudinally moving firing rod contacts the staple drive member on one jaw. The staple drive member pushes the surgical staple through the body tissue and into the opposite jaw anvil which crimps the staple. When tissue is removed or separated, a knife blade can be provided on the jaws of the device to cut tissue between multiple lines of staples.

相対的に薄い、または脆弱な組織をステープル留めする場合、ステープル線を空気または流体の漏洩に対して有効に密閉することが重要である。その上、組織の断裂または組織を通すステープルの引っ張りを防止するために、組織に対してステープル線を補強することがたびたび必要である。断裂またはステープルが抜けることを防止する１つの方法は、ステープルのバックスパンと下にある組織との間への補強材料または“バットレス”材料の配置を伴う。この方法では、バットレス材料の層が組織に対して配置され、組織は従来の態様でステープル留めされる。さらに新しい方法では、バットレス材料は、組織をステープル留めする前に、ステープル留めの器具そのものに位置づけされる。この例は、ＭｃＫｅａｎらによる特許文献１に開示されている。ＭｃＫｅａｎらの文献では、チューブ状のバットレス材料がステープラーの顎の上にかぶせられる。ステープラーは、次に、対象組織をステープル留めし、組織およびステープル線を補強するように組織とステープル線との間にバットレス材料を固定するために起動される。   When stapling relatively thin or fragile tissue, it is important to effectively seal the staple lines against air or fluid leakage. In addition, it is often necessary to reinforce the staple lines against the tissue in order to prevent tissue tearing or pulling of the staples through the tissue. One way to prevent tearing or pulling of the staples involves the placement of reinforcing or “buttress” material between the staple backspan and the underlying tissue. In this method, a layer of buttress material is placed against the tissue and the tissue is stapled in a conventional manner. In a newer method, the buttress material is positioned on the stapling instrument itself prior to stapling the tissue. An example of this is disclosed in US Pat. In McKean et al., A tubular buttress material is placed over the jaws of the stapler. The stapler is then activated to staple the target tissue and secure the buttress material between the tissue and the staple line to reinforce the tissue and staple line.

米国特許第５，５４２，５９４号明細書US Pat. No. 5,542,594

従って、外科手術用ステープル留め器具のアンビルに局部的補強材料を取り付けるシステムを提供することが所望される。補強材料を切らなければならないことを回避するように材料がステープル線の両側に局部的に集中するように、外科ステープル留め器具のアンビルに形成されたナイフの溝の両側に少量のバットレス材料を取り付けるシステムを提供することがさらに所望される。補強材料を貫通することなく組織に補強材料をさらに固定するために、外科手術用ステープルの組織貫通端を補強材料の上に、そして再び組織の中へ曲げるように構成されるステープルをクリンチするポケットを有するアンビルを提供することがなおさらに所望される。   Accordingly, it is desirable to provide a system for attaching a local reinforcing material to an anvil of a surgical stapling instrument. A small amount of buttress material is attached to both sides of the knife groove formed in the anvil of the surgical stapling instrument so that the material concentrates locally on both sides of the staple line so as to avoid having to cut the reinforcing material It is further desirable to provide a system. A pocket for clinching the staple configured to bend the tissue penetrating end of the surgical staple over the reinforcement material and back into the tissue to further secure the reinforcement material to the tissue without penetrating the reinforcement material It is still further desired to provide an anvil having

長手方向の軸、第一ステープル折り曲げポケット、および第二ステープル折り曲げポケットを有するアンビル部材を概して含む外科手術用ステープル留め器具との使用のためのアンビルアセンブリがここに開示される。アンビルアセンブリは、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットにわたって伸長する一本の補強材料を追加的に含む。補強材料の幅は、ステープルのレッグが補強材料を貫通することなく補強材料の周りに形成され得るように、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットの幅より狭い。第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットのそれぞれは、楕円形状であり、アンビル部材の長手方向の軸に対して角度をもって形成される長手方向の軸を有する。   Disclosed herein is an anvil assembly for use with a surgical stapling instrument that generally includes an anvil member having a longitudinal axis, a first staple folding pocket, and a second staple folding pocket. The anvil assembly additionally includes a reinforcement material extending across the first staple fold pocket and the second staple fold pocket. The width of the reinforcing material is narrower than the width of the first staple folding pocket and the second staple folding pocket so that the staple legs can be formed around the reinforcing material without penetrating the reinforcing material. Each of the first staple folding pocket and the second staple folding pocket is elliptical and has a longitudinal axis formed at an angle with respect to the longitudinal axis of the anvil member.

１つの実施形態では、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットの長手方向の軸は、互いに対して平行である。別の実施形態では、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットの長手方向の軸は、アンビル部材の長手方向の軸に対して直角である。   In one embodiment, the longitudinal axes of the first staple folding pocket and the second staple folding pocket are parallel to each other. In another embodiment, the longitudinal axes of the first staple folding pocket and the second staple folding pocket are perpendicular to the longitudinal axis of the anvil member.

１つの他の実施形態では、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットは、アンビル部材の長手方向の軸に向かって収束する。さらに他の実施形態では、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットの長手方向の軸は、アンビル部材の長手方向の軸から離れて広がる。   In one other embodiment, the first staple fold pocket and the second staple fold pocket converge toward the longitudinal axis of the anvil member. In yet other embodiments, the longitudinal axes of the first staple folding pocket and the second staple folding pocket extend away from the longitudinal axis of the anvil member.

アンビル部材は、補強材料の受け入れのための、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットにわたって伸長する長手方向のトラフを含む。長手方向のトラフは、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットにわたって補強部材を吊り下げる。トラフは、アンビル部材の補強材料を解放可能に保持するために、補強材料の幅より狭い幅を伴う開きを有する。特定の実施形態では、補強材料はワイヤである。   The anvil member includes a longitudinal trough extending across the first staple fold pocket and the second staple fold pocket for receipt of a reinforcing material. The longitudinal trough suspends the reinforcing member across the first staple folding pocket and the second staple folding pocket. The trough has an opening with a width that is narrower than the width of the reinforcing material to releasably hold the reinforcing material of the anvil member. In certain embodiments, the reinforcing material is a wire.

長手方向の軸を有するバックスパン、バックスパンから伸長する第一レッグ、およびバックスパンから伸長する第二レッグを有する完全に形成された外科手術用ステープルもここで開示される。それぞれの第一レッグおよび第二レッグは、組織貫通先端部で終端する。第一レッグは、バックスパンの長手方向の軸と平面を定義する長手方向の軸を有する第一部分と、バックスパンの長手方向の軸と第一部分により定義される平面の外側に突出する第二部分を含む。第二部分は、補強材料を取り囲むように鉤形状を有する。また、第二レッグは、バックスパンから伸長し平面内に位置する第一部分と、第一部分から伸長し平面の外側に突出する第二部分を含む。   Also disclosed herein is a fully formed surgical staple having a backspan having a longitudinal axis, a first leg extending from the backspan, and a second leg extending from the backspan. Each first and second leg terminates at a tissue penetrating tip. The first leg has a first portion having a longitudinal axis that defines a longitudinal axis and a plane of the backspan, and a second portion that projects outside the plane defined by the longitudinal axis and the first portion of the backspan. including. The second part has a bowl shape so as to surround the reinforcing material. The second leg includes a first portion extending from the backspan and positioned in the plane, and a second portion extending from the first portion and protruding outside the plane.

１つの実施形態では、第一レッグの第二部分と、第二レッグの第二部分は、互いに対して平行である。別の実施形態では、第一レッグの第二部分と、第二レッグの第二部分は、バックスパンの長手方向の軸に対して直角である。   In one embodiment, the second part of the first leg and the second part of the second leg are parallel to each other. In another embodiment, the second portion of the first leg and the second portion of the second leg are perpendicular to the longitudinal axis of the backspan.

さらなる実施形態では、第一レッグの第二部分と、第二レッグの第二部分は、互いに向かって内側に収束し、バックスパンの長さ内にある。   In a further embodiment, the second portion of the first leg and the second portion of the second leg converge inward toward each other and are within the length of the backspan.

さらなる他の実施形態では、第一レッグの第二部分と、第二レッグの第二部分は、互いに対し異なる方向に広がり、バックスパンの長さを超えて伸長する。   In still other embodiments, the second portion of the first leg and the second portion of the second leg extend in different directions relative to each other and extend beyond the length of the backspan.

本開示のアンビルアセンブリ、およびそれにより形成される外科手術用ステープルの様々な実施形態は、図面への参照と共にこの明細書に開示される。   Various embodiments of the anvil assembly of the present disclosure and the surgical staples formed thereby are disclosed herein with reference to the drawings.

本発明は例えば以下を提供する。
（項目１） 長手方向の軸、第一ステープル折り曲げポケット、および第二ステープル折り曲げポケットを有するアンビル部材と、
該第一ステープル折り曲げポケットおよび該第二ステープル折り曲げポケットにわたって伸長する一本の補強部材と
を含み、該補強部材の幅は、該第一ステープル折り曲げポケットおよび該第二ステープル折り曲げポケットの幅よりも狭い、外科手術用ステープル留め器具との使用のためのアンビルアセンブリ。
（項目２） 上記第一ステープル折り曲げポケットおよび上記第二ステープル折り曲げポケットのそれぞれは、楕円形状であり、上記アンビル部材の長手方向の軸に対して角度をもって形成される長手方向の軸を有する、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目３） 上記第一ステープル折り曲げポケットの長手方向の軸と上記第二ステープル折り曲げポケットの長手方向の軸とは、互いに平行である、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目４） 上記第一ステープル折り曲げポケットの長手方向の軸と上記第二ステープル折り曲げポケットの長手方向の軸とは、上記アンビル部材の長手方向の軸に対して直角である、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目５） 上記第一ステープル折り曲げポケットの長手方向の軸と上記第二ステープル折り曲げポケットの長手方向の軸とは、上記アンビル部材の長手方向の軸に向かって収束する、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目６） 上記第一ステープル折り曲げポケットの長手方向の軸と上記第二ステープル折り曲げポケットの長手方向の軸とは、上記アンビル部材の長手方向の軸から離れて広がる、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目７） 上記アンビル部材は、上記補強部材の受け入れのための長手方向のトラフを含み、上記長手方向のトラフは、上記第一ステープル折り曲げポケットおよび上記第二ステープル折り曲げポケットにわたって伸長する、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目８） 上記トラフは、上記補強部材の幅よりも狭い幅を有する開きを有する、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目９） 上記長手方向のトラフは、上記第一ステープル折り曲げポケットおよび上記第二ステープル折り曲げポケットにわたって上記補強部材を吊り下げる、上記項目のいずれか１項に記載のアンビルアセンブリ。
（項目１０） 長手方向の軸を有するバックスパンと、
上記バックスパンから伸長する第一レッグと、
上記バックスパンから伸長する第二レッグと
を含み、上記第一レッグおよび上記第二レッグのそれぞれは、組織貫通先端部で終端し、上記第一レッグは、上記バックスパンの長手方向の軸と平面を画定する長手方向の軸を有する第一部分、および上記バックスパンの長手方向の軸と上記第一部分とにより画定される上記平面の外側に突出する第二部分を含む、完全に形成された外科手術用ステープル。
（項目１１） 上記第二部分は鉤形状を有する、上記項目のいずれか１項に記載の完全に形成された外科手術用ステープル。
（項目１２） 上記第二レッグは、上記バックスパンから伸長し、上記平面内に位置する第一部分、および上記第一部分から伸長し、上記平面の外側に突出する第二部分を含む、上記項目のいずれか１項に記載の完全に形成された外科手術用ステープル。
（項目１３） 上記第一レッグの第二部分、および上記第二レッグの第二部分は、互いに平行である、上記項目のいずれか１項に記載の完全に形成された外科手術用ステープル。
（項目１４） 上記第一レッグの第二部分、および上記第二レッグの第二部分は、上記バックスパンの長手方向の軸に対して直角である、上記項目のいずれか１項に記載の完全に形成された外科手術用ステープル。
（項目１５） 上記第一レッグの第二部分、および上記第二レッグの第二部分は、互いに向かって内側に収束し、上記バックスパンの長さ内にある、上記項目のいずれか１項に記載の完全に形成された外科手術用ステープル。
（項目１６） 上記第一レッグの第二部分、および上記第二レッグの第二部分は、互いから離れて広がり、上記バックスパンの長さを超えて伸長する、上記項目のいずれか１項に記載の完全に形成された外科手術用ステープル。
（項目１７） 細長い部材と、
上記細長い部材の近位端にあるハンドルアセンブリと、
上記細長い部材の遠位端にあるエンドエフェクタと
を含み、上記エンドエフェクタは、請求項１に従ったアンビルアセンブリと、ステープルカートリッジとを含み、上記アンビルアセンブリおよび上記ステープルカートリッジは、互いに対して可動的である、外科手術用ステープル留め器具。
（項目１８） 上記アンビル部材は、上記補強部材の受け入れのための長手方向のトラフを含む、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目１９） 上記長手方向のトラフは、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットにわたって伸長する、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２０） 上記トラフは、上記補強部材の幅よりも狭い幅の開きを有する、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２１） 上記長手方向のトラフは、上記第一ステープル折り曲げポケットおよび上記第二ステープル折り曲げポケットにわたって上記補強部材を吊り下げる、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２２） 上記ステープルカートリッジは、複数のステープル保持ポケットを伴う本体部分を有する、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２３） 上記ステープル保持ポケットは、それぞれ、ステープルを含む、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２４） 上記ハンドルアセンブリに動作的に関連する駆動棒をさらに含む、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２５） 上記ハンドルアセンブリはトリガーを含む、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２６） 上記ステープルカートリッジは、そりを有する、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２７） 上記補強部材は、ワイヤ、縫合糸、または材料片から成るグループから選択される、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２８） 上記補強部材の長さは、２つより多くのステープル折り曲げポケットにわたって伸長する、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。
（項目２９） 上記アンビル部材は、円状アンビル部材および弓状アンビル部材から成るグループから選択される、上記項目のいずれか１項に記載の外科手術用ステープル留め器具。 For example, the present invention provides the following.
(Item 1) An anvil member having a longitudinal axis, a first staple folding pocket, and a second staple folding pocket;
A reinforcing member extending across the first staple folding pocket and the second staple folding pocket, wherein the width of the reinforcing member is narrower than the width of the first staple folding pocket and the second staple folding pocket An anvil assembly for use with a surgical stapling instrument.
(Item 2) Each of the first staple folding pocket and the second staple folding pocket is elliptical and has a longitudinal axis formed at an angle with respect to the longitudinal axis of the anvil member. An anvil assembly according to any one of the items.
(Item 3) The anvil assembly according to any one of the preceding items, wherein a longitudinal axis of the first staple folding pocket and a longitudinal axis of the second staple folding pocket are parallel to each other.
(Item 4) Any of the above items, wherein the longitudinal axis of the first staple folding pocket and the longitudinal axis of the second staple folding pocket are perpendicular to the longitudinal axis of the anvil member. The anvil assembly according to claim 1.
(Item 5) Any one of the above items, wherein the longitudinal axis of the first staple folding pocket and the longitudinal axis of the second staple folding pocket converge toward the longitudinal axis of the anvil member. An anvil assembly as described in the paragraph.
(Item 6) Any one of the above items, wherein the longitudinal axis of the first staple folding pocket and the longitudinal axis of the second staple folding pocket extend away from the longitudinal axis of the anvil member. Anvil assembly as described in.
(Item 7) The item, wherein the anvil member includes a longitudinal trough for receiving the reinforcing member, the longitudinal trough extending over the first staple folding pocket and the second staple folding pocket. The anvil assembly according to claim 1.
(Item 8) The anvil assembly according to any one of the preceding items, wherein the trough has an opening having a width narrower than a width of the reinforcing member.
(Item 9) The anvil assembly according to any one of the preceding items, wherein the trough in the longitudinal direction suspends the reinforcing member across the first staple folding pocket and the second staple folding pocket.
(Item 10) A backspan having a longitudinal axis;
A first leg extending from the backspan;
A second leg extending from the backspan, each of the first leg and the second leg terminating at a tissue penetrating tip, wherein the first leg is planar with a longitudinal axis of the backspan. A fully formed surgical procedure, comprising: a first portion having a longitudinal axis that defines a first portion; and a second portion projecting out of the plane defined by the longitudinal axis of the backspan and the first portion. For staples.
11. The fully formed surgical staple according to any one of the preceding items, wherein the second portion has a heel shape.
(Item 12) The second item, wherein the second leg includes a first portion that extends from the backspan and is located in the plane, and a second portion that extends from the first portion and projects outside the plane. A fully formed surgical staple according to any one of the preceding claims.
13. The fully formed surgical staple of any one of the preceding items, wherein the second portion of the first leg and the second portion of the second leg are parallel to each other.
(Item 14) A complete portion according to any one of the preceding items, wherein the second portion of the first leg and the second portion of the second leg are perpendicular to the longitudinal axis of the backspan. Surgical staples formed into.
(Item 15) In any one of the preceding items, the second portion of the first leg and the second portion of the second leg converge inward toward each other and are within the length of the backspan. A fully formed surgical staple as described.
(Item 16) In any one of the preceding items, wherein the second portion of the first leg and the second portion of the second leg extend away from each other and extend beyond the length of the backspan. A fully formed surgical staple as described.
(Item 17) an elongated member;
A handle assembly at a proximal end of the elongate member;
An end effector at a distal end of the elongate member, the end effector comprising an anvil assembly according to claim 1 and a staple cartridge, wherein the anvil assembly and the staple cartridge are movable relative to each other. A surgical stapling instrument.
(Item 18) The surgical stapling instrument according to any one of the preceding items, wherein the anvil member includes a longitudinal trough for receiving the reinforcing member.
19. The surgical stapling instrument according to any one of the preceding items, wherein the longitudinal trough extends across the first staple folding pocket and the second staple folding pocket.
(Item 20) The surgical stapling instrument according to any one of the preceding items, wherein the trough has an opening that is narrower than a width of the reinforcing member.
(Item 21) The surgical stapling instrument according to any one of the preceding items, wherein the longitudinal trough suspends the reinforcing member across the first staple folding pocket and the second staple folding pocket.
(Item 22) The surgical stapling instrument according to any one of the preceding items, wherein the staple cartridge has a body portion with a plurality of staple holding pockets.
(Item 23) The surgical stapling instrument according to any one of the preceding items, wherein each of the staple holding pockets includes a staple.
24. The surgical stapling instrument of any one of the preceding items, further comprising a drive rod operatively associated with the handle assembly.
25. The surgical stapling instrument according to any one of the preceding items, wherein the handle assembly includes a trigger.
(Item 26) The surgical stapling instrument according to any one of the preceding items, wherein the staple cartridge has a sled.
(Item 27) The surgical stapling instrument according to any one of the preceding items, wherein the reinforcing member is selected from the group consisting of a wire, a suture, or a piece of material.
28. The surgical stapling instrument according to any one of the preceding items, wherein the length of the reinforcing member extends over more than two staple folding pockets.
29. The surgical stapling instrument according to any one of the preceding items, wherein the anvil member is selected from the group consisting of a circular anvil member and an arcuate anvil member.

（摘要）
アンビルアセンブリが提供され、アンビル部材前面に形成される複数のステープル折り曲げポケットを有するアンビル部材、およびステープル折り曲げポケットにわたって吊り下げられる一本の補強材料を含む。長手方向のチャネルが、補強材料を解放可能に保持するためにアンビル部材前面に提供される。長手方向のチャネルは、ステープル折り曲げポケットを縦断し、外科手術用ステープルのレッグが補強材料の周りに折り曲げられ得るようにステープル折り曲げポケットの上に補強材料を支持し吊り下げる。また、完全形成されたステープルの様々な構成が開示され、バックスパンから伸長する第一、第二レッグを有するバックスパンを含む。第一、第二レッグの第一部分は、それぞれバックスパンから伸長し、バックスパンと平面を画定する。第一、第二レッグそれぞれの第二部分は、第一部分から伸長し、バックスパンと第一部分とにより画定される平面から外側に突出する。 (Summary)
An anvil assembly is provided and includes an anvil member having a plurality of staple folding pockets formed on the front surface of the anvil member, and a reinforcing material suspended over the staple folding pockets. A longitudinal channel is provided on the front surface of the anvil member to releasably hold the reinforcing material. The longitudinal channel traverses the staple folding pocket and supports and suspends the reinforcing material over the staple folding pocket so that the legs of the surgical staple can be folded around the reinforcing material. Various configurations of fully formed staples are also disclosed, including a backspan having first and second legs extending from the backspan. The first portions of the first and second legs each extend from the backspan and define a backspan and a plane. A second portion of each of the first and second legs extends from the first portion and protrudes outward from a plane defined by the backspan and the first portion.

図１は、アンビルアセンブリの１つの実施形態を組み込む外科手術用ステープル留め器具の斜視図である。FIG. 1 is a perspective view of a surgical stapling instrument incorporating one embodiment of an anvil assembly. 図２は、図１のアンビルアセンブリを使用して補強材料もしくは補強部材の周りに形成された一連の外科手術用ステープルの斜視図である。FIG. 2 is a perspective view of a series of surgical staples formed around a reinforcing material or member using the anvil assembly of FIG. 図３は、アンビルおよび補強部材を含むアンビルアセンブリの１つの実施形態の斜視図である。FIG. 3 is a perspective view of one embodiment of an anvil assembly including an anvil and a reinforcing member. 図４は、図３のアンビルのアンビル面の平面図である。FIG. 4 is a plan view of the anvil surface of the anvil of FIG. 図５は、図４の線５−５に沿って取られた断面図である。FIG. 5 is a cross-sectional view taken along line 5-5 of FIG. 図６は、図４の線６−６に沿って取られた断面図である。6 is a cross-sectional view taken along line 6-6 of FIG. 図７は、組織区分の周りに位置づけされた図１の外科手術用ステープル留め器具の遠位端の断面図である。7 is a cross-sectional view of the distal end of the surgical stapling instrument of FIG. 1 positioned around a tissue section. 図８は、図７の線８−８に沿って取られた断面図である。FIG. 8 is a cross-sectional view taken along line 8-8 of FIG. 図９は、組織を通してアンビルに駆動される一連の外科手術用ステープルを描写する、図７に同様な断面図である。FIG. 9 is a cross-sectional view similar to FIG. 7 depicting a series of surgical staples driven through tissue to an anvil. 図１０は、補強部材の周りに形成される１つの外科手術用ステープルの組織貫通端を描写する、図９の線１０−１０に沿って取られた断面図である。FIG. 10 is a cross-sectional view taken along line 10-10 of FIG. 9 depicting the tissue penetrating end of one surgical staple formed around the reinforcing member. 図１１は、補強部材の周りに形成される一連のステープルにより固定された１組の組織区分の斜視図である。FIG. 11 is a perspective view of a set of tissue sections secured by a series of staples formed around a reinforcing member. 図１２は、補強部材の上に形成される別の一連の外科手術用ステープルの斜視図である。FIG. 12 is a perspective view of another series of surgical staples formed on a reinforcing member. 図１３は、図１２のステープルを形成するために使用されるアンビルの他の実施形態の平面図である。13 is a plan view of another embodiment of an anvil used to form the staple of FIG. 図１４は、補強部材の上に形成されるさらなる一連の外科手術用ステープルの斜視図である。FIG. 14 is a perspective view of a further series of surgical staples formed on a reinforcing member. 図１５は、図１４のステープルを形成するために使用されるアンビルのさらなる他の実施形態の平面図である。15 is a plan view of yet another embodiment of an anvil used to form the staple of FIG. 図１６は、補強部材の上に形成されるなお他の一連の外科手術用ステープルの斜視図である。FIG. 16 is a perspective view of yet another series of surgical staples formed on a reinforcing member. 図１７は、図１６のステープルを形成するために使用されるアンビルの別の他の実施形態の平面図である。17 is a plan view of another embodiment of an anvil used to form the staple of FIG. 図１８は、補強部材の周りに複数の外科手術用ステープルの列を形成するために使用されるアンビルのさらなる他の実施形態の平面図である。FIG. 18 is a plan view of yet another embodiment of an anvil used to form a plurality of rows of surgical staples around a reinforcing member.

（実施形態の詳細な説明）
本開示のアンビルアセンブリ、およびそれにより形成される外科手術用ステープルの実施形態がここで図面への参照と共に詳細に記述され、同様な数字は、いくつかの図のそれぞれの同一要素または対応する要素を指定する。この技術分野では一般的であるように、“近位”という用語は、ユーザーまたは作業者（すなわち外科医、または内科医）により近いその部位またはコンポーネントを指し、“遠位”という用語は、ユーザーからより遠いその部位またはコンポーネントを指す。 (Detailed description of embodiment)
Embodiments of the presently disclosed anvil assembly, and the surgical staples formed thereby, will now be described in detail with reference to the drawings, wherein like numerals indicate like or corresponding elements in each of the several views. Is specified. As is common in the art, the term “proximal” refers to that site or component that is closer to the user or operator (ie, the surgeon or physician) and the term “distal” Refers to that part or component that is further away.

図１を参照すると、アンビルアセンブリ１２の１つの実施形態を組み込む外科手術用サンプリング器具１０がここに描写される。外科手術用サンプリング器具１０は、概してハンドル１４から遠位に伸長する細長い筒状部材１６を有するピストルグリップ様式のハンドル１４を含む。エンドエフェクタ１８は、細長い筒状部材１６の遠位端２０から遠位に伸長し、アンビルアセンブリ１２およびステープルカートリッジ２２を含む。アンビルアセンブリ１２は、ステープルカートリッジ２２に対して可動的に装着される。トリガー２４はハンドル１４に提供され、アンビルアセンブリ１２を、ステープルカートリッジ２２から離れた開いた位置から、アンビルアセンブリ１２をステープルカートリッジ２２と近い協力的な整列に持ってくる閉じた位置へと動かすように操作可能である。回転ノブ２６が、手術される組織に対してエンドエフェクタ１８を回転および配向するためにハンドル１４に提供される。   Referring to FIG. 1, a surgical sampling instrument 10 that incorporates one embodiment of an anvil assembly 12 is depicted herein. Surgical sampling instrument 10 includes a pistol grip style handle 14 having an elongated tubular member 16 that extends generally distally from handle 14. The end effector 18 extends distally from the distal end 20 of the elongated tubular member 16 and includes an anvil assembly 12 and a staple cartridge 22. The anvil assembly 12 is movably attached to the staple cartridge 22. A trigger 24 is provided on the handle 14 to move the anvil assembly 12 from an open position away from the staple cartridge 22 to a closed position that brings the anvil assembly 12 in close cooperative alignment with the staple cartridge 22. It is possible to operate. A rotation knob 26 is provided on the handle 14 for rotating and orienting the end effector 18 relative to the tissue to be operated on.

ここで図２を参照すると、補強部材またはワイヤ３０の上に形成される一連の外科手術用ステープル２８ａ、２８ｂ、２８ｃなどがここに開示される。ワイヤ３０は、一緒にステープル留めされる一組の組織端の全長に沿って一様な留め圧力を確実にするために提供される。これは、ステープル２８ａ、２８ｂ、２８ｃが、それ自身により組織を一様に留めることに不充分であり得る相対的に柔軟な材料で形成されるときに特に有効である。開示されたステープル２８ａ、２８ｂ、２８ｃなど、および補強部材もしくはワイヤ３０は、様々な材料から形成され得る。これらの材料は、例えばステンレス鋼、チタンなどのような金属材料を含み得る。あるいは、これらは、様々な重合体または吸収性材料から形成され得る。ステープル２８ａ、２８ｂ、および２８ｃは、アンビルアセンブリ１２に駆動された後の完全に形成された状態で示されている。開示されたステープルの以下の論考は、ステープル２８ａに関してされる。   Referring now to FIG. 2, a series of surgical staples 28a, 28b, 28c, etc. formed on a reinforcing member or wire 30 are now disclosed. Wire 30 is provided to ensure uniform clamping pressure along the entire length of a set of tissue ends that are stapled together. This is particularly effective when the staples 28a, 28b, 28c are formed of a relatively soft material that may be insufficient to hold the tissue uniform by itself. The disclosed staples 28a, 28b, 28c, etc., and the reinforcing member or wire 30 may be formed from a variety of materials. These materials may include metallic materials such as stainless steel, titanium and the like. Alternatively, they can be formed from a variety of polymers or absorbent materials. Staples 28a, 28b, and 28c are shown in a fully formed state after being driven to anvil assembly 12. The following discussion of the disclosed staples is made with respect to staples 28a.

ステープル２８ａは、第一レッグ３４および第二レッグ３６を有するバックスパン３２を概して含み、第一レッグ３４は、バックスパン３２から伸長し、第一組織貫通先端部３８で終端し、第二レッグは、バックスパン３２から伸長し、第二組織貫通先端部４０で終端する。第一レッグ３４および第二レッグ３６は、バックスパン３２から伸長するそれぞれ第一部分４２および４４を含む。第一レッグ３４および第二レッグ３６の第二部分４６および４８は、それぞれ第一部分４２および４４から伸長し、組織貫通先端部３８および４０で終端する。   Staple 28a generally includes a backspan 32 having a first leg 34 and a second leg 36, where the first leg 34 extends from the backspan 32 and terminates at a first tissue penetrating tip 38, the second leg being , Extending from the backspan 32 and terminating at the second tissue penetrating tip 40. First leg 34 and second leg 36 include first portions 42 and 44 respectively extending from backspan 32. Second portions 46 and 48 of first leg 34 and second leg 36 extend from first portions 42 and 44, respectively, and terminate at tissue penetrating tips 38 and 40.

形成される前の状態では、第一レッグ３４および第二レッグ３６は、概ねまっすぐである。例えば、第一レッグ３４の第一部分４２および第二部分４６は、まっすぐであり、共通の軸ｙ−ｙに沿って位置する。しかし、完全に形成された状態では、各レッグの第二部分、例えば第一レッグ３４の第二部分４６は、第一部分４２の軸ｙ−ｙとバックスパン３２の長手方向の軸ｘ−ｘとにより画定される平面の外に位置する折れ曲がりまたは鉤を形成する。   In the state prior to being formed, the first leg 34 and the second leg 36 are generally straight. For example, the first portion 42 and the second portion 46 of the first leg 34 are straight and located along a common axis yy. However, in the fully formed state, the second portion of each leg, eg, the second portion 46 of the first leg 34, has an axis yy of the first portion 42 and a longitudinal axis xx of the back span 32. Forming a fold or fold located outside the plane defined by.

ここで図３を参照すると、アンビルアセンブリ１２は、補強部材もしくはワイヤ３０、およびアンビル面５２を有するアンビル部材５０を概して含む。アンビル部材５０は、アンビル部材５０の実質的に全長に伸長するナイフスロット５４を含む。ナイフスロット５４は、アンビルアセンブリ１２とステープルカートリッジ２２との間で捕捉される組織を切断するために提供される。ステープル折り曲げポケットの列５６および５８は、アンビル面５２に沿ってナイフスロット５４の両側で長さの方向に伸長する。ステープル折り曲げポケットの列５６および５８は、この明細書に以下でさらに詳細に記述されるように、開示されたステープルの各レッグの第二部分を、それらの折り曲げられた形状または鉤状の形状に形成するために提供される。   With reference now to FIG. 3, the anvil assembly 12 generally includes an anvil member 50 having a reinforcing member or wire 30 and an anvil surface 52. Anvil member 50 includes a knife slot 54 that extends substantially the entire length of anvil member 50. A knife slot 54 is provided to cut tissue that is captured between the anvil assembly 12 and the staple cartridge 22. Staple folding pocket rows 56 and 58 extend longitudinally on both sides of knife slot 54 along anvil surface 52. Staple folding pocket rows 56 and 58 provide a second portion of each leg of the disclosed staples in their folded or saddle shape, as described in further detail herein below. Provided to form.

例えばワイヤ３０のような補強部材をアンビル面５２に一時的に支持するために、１組の長手方向のトラフまたはチャネル６０および６２が、アンビル面５２に沿って長手方向に伸長し、ステープル折り曲げポケットの列５６および５８にわたって伸長する。   A set of longitudinal troughs or channels 60 and 62 extend longitudinally along the anvil surface 52 to temporarily support a reinforcement member, such as wire 30, for example, on the anvil surface 52, and staple folding pockets. Extends across rows 56 and 58 of

ここで図４を参照すると、それぞれのステープル折り曲げポケットの列５６および５８は、組織の周りに開示されたステープルのレッグを形成するために、ステープル折り曲げポケットの組（それぞれ６４および６６）を含む。例えば、１組のステープル折り曲げポケット６４は、概ね楕円状の第一ステープル折り曲げポケット６８、および概ね楕円状の第二ステープル折り曲げポケット７０を含む。この明細書の以前の部分で示されたように、ステープル２８ａの第二部分４６および４８は、バックスパン３２の長手方向の軸ｘ−ｘに対して実質的に直角な折り曲げられた構成または鉤状の構成に形成される。この直角の配向を得るために、アンビル部材５０は、長手方向の軸Ａ−Ａを含み、ステープル折り曲げポケット６８および７０は、長手方向の軸Ａ−Ａに対して直角に配向される。特に、楕円状のステープル折り曲げポケット６８の長手方向の軸Ｂ−Ｂは、アンビル部材５０の長手方向の軸Ａ−Ａに対して直角である。   Referring now to FIG. 4, each staple folding pocket row 56 and 58 includes a set of staple folding pockets (64 and 66, respectively) to form the disclosed staple legs around the tissue. For example, the set of staple folding pockets 64 includes a generally elliptical first staple folding pocket 68 and a generally elliptical second staple folding pocket 70. As shown in previous portions of this specification, the second portions 46 and 48 of the staple 28a are folded configurations or ridges substantially perpendicular to the longitudinal axis xx of the backspan 32. It is formed in a shape configuration. To obtain this perpendicular orientation, the anvil member 50 includes a longitudinal axis AA, and the staple folding pockets 68 and 70 are oriented perpendicular to the longitudinal axis AA. In particular, the longitudinal axis BB of the elliptical staple folding pocket 68 is perpendicular to the longitudinal axis AA of the anvil member 50.

一時的に図５および図６を参照すると、この明細書の以前の部分で示されたように、トラフまたはチャネル６０は、ワイヤ３０をアンビル部材５０のアンビル面５２に沿って、ステープル折り曲げポケットの列の上に支持するために提供される。図５で最良に示されるように、ワイヤ３０がステープル折り曲げポケット６８のようなステープル折り曲げポケットの上を通過するとき、ワイヤ３０は、開示された外科手術用ステープルの第二部分がワイヤ３０の下を通過すること、および開示された外科手術用ステープルの第二部分がステープル折り曲げポケット６８内で折り曲げられることを可能にする充分な高さｈをもってトラフ６０内で支持される。   Referring temporarily to FIGS. 5 and 6, as shown earlier in this specification, the trough or channel 60 causes the wire 30 to run along the anvil surface 52 of the anvil member 50 and the staple folding pocket. Provided to support on the row. As best shown in FIG. 5, when the wire 30 passes over a staple folding pocket, such as the staple folding pocket 68, the wire 30 has a second portion of the disclosed surgical staple under the wire 30. And a second portion of the disclosed surgical staple is supported in the trough 60 with sufficient height h to allow it to be folded in the staple folding pocket 68.

ここで図６を参照すると、この明細書の以前の部分で示されたように、ワイヤ３０は、トラフ６０内でアンビル面５２に沿って一時的に支持される。トラフ６０は、アンビル部材５０からの意図的でないまたは時期尚早なワイヤ３０の解放を防止するために、トラフ６０内でワイヤ３０を一時的につまむまたは保持するために、ワイヤ３０の幅より若干狭い開き７２をもって形成される。   Referring now to FIG. 6, the wire 30 is temporarily supported along the anvil surface 52 within the trough 60 as shown in the previous portion of this specification. The trough 60 is slightly narrower than the width of the wire 30 to temporarily pinch or hold the wire 30 within the trough 60 to prevent unintentional or premature release of the wire 30 from the anvil member 50. An opening 72 is formed.

注意すべきは、補強部材は、ワイヤ、縫合糸、１束の材料、１切れの材料、または１タブレットの材料から成り得ることである。補強材料は、特定の好ましい実施形態では、ステープル折り曲げポケットの幅より狭い。補強部材は、１つより多くのステープル折り曲げポケットを横切る長さで延び得る。   It should be noted that the reinforcing member can be made of wire, suture, a bundle of material, a piece of material, or a tablet of material. The reinforcing material is narrower than the width of the staple folding pocket in certain preferred embodiments. The reinforcing member may extend a length across more than one staple folding pocket.

ここで図７−１０を参照すると、１組の組織区分を固定させるためのアンビルアセンブリ１２（補強ワイヤ３０を含む）と、例えばステープル２８ａのような開示されたステープルとの使用がここで記述される。この明細書の以前の部分で示されたように、外科手術用ステープル留め器具１０は、アンビルアセンブリ１２およびステープルカートリッジ２２を含む、細長い部材１６の遠位端２０から遠位に伸長するエンドエフェクタ１８を含む。図２から図６に関連して上記されたアンビルアセンブリ１２、およびステープルカートリッジ２２は、その間に組織が留められ得るように、互いに対して可動的である。図７に最良に示されるように、アンビル部材５０は、この明細書の以前の部分で記述されたステープル折り曲げポケット６８および７０と同一である１組の近位ステープル折り曲げポケット７４および７６を含む。ステープルカートリッジ２２は、手術用ステープル２８ａ、２８ｂ、２８ｃなどを保持するために提供される、例えばステープル保持ポケット８０、８２、８４などのような複数のステープル保持ポケットを有する本体部分７８を概して含む。プッシャー８６、８８、９０などが、ステープル保持ポケット８０、８２、および８４内に含まれる手術用ステープルを支持するために、それぞれのステープル保持ポケット８０、８２、および８４内に提供される。ハンドルは、細長い部材１６の近位端にある。駆動棒９１（図９）は、ステープルカートリッジにわたって駆動棒９１を移動させるために、手術用サンプリング器具１０（図１）のトリガー２４に操作的に連結される。そり９２は、駆動棒９１に隣接して位置づけされる。駆動棒９１およびそり９２は、外科手術用ステープル２８ａのような開示された手術用ステープルを、ステープルポケット８０からアンビル部材５０のステープル折り曲げポケット７４および７６に向かって駆動するために提供される。特定の実施形態では、そりは、ステープルプッシャーと相互作用するための傾斜のついたまたは楔形の表面を有する。駆動棒がステープルカートリッジにわたって移動するにつれ、そりは同方向に移動し、ステープルプッシャーを押し、ステープルプッシャーは、アンビル部材に対してステープルを本体部分７８から打ちだす。米国特許番号５，７６２，２５６および５，８６５，３６１に開示されるそりおよびプッシャーが使用され得、その開示の全体は、この明細書に参照により援用される。   Referring now to FIGS. 7-10, the use of the anvil assembly 12 (including the reinforcing wire 30) and the disclosed staples, such as staples 28a, for securing a set of tissue sections will now be described. The As indicated earlier in this specification, surgical stapling instrument 10 includes an end effector 18 that extends distally from a distal end 20 of an elongate member 16 that includes an anvil assembly 12 and a staple cartridge 22. including. The anvil assembly 12 and the staple cartridge 22 described above in connection with FIGS. 2-6 are movable relative to each other so that tissue can be clamped therebetween. As best shown in FIG. 7, the anvil member 50 includes a set of proximal staple folding pockets 74 and 76 that are identical to the staple folding pockets 68 and 70 described earlier in this specification. Staple cartridge 22 generally includes a body portion 78 having a plurality of staple holding pockets, such as staple holding pockets 80, 82, 84, etc., provided to hold surgical staples 28a, 28b, 28c, and the like. Pushers 86, 88, 90, etc. are provided within the respective staple holding pockets 80, 82, and 84 to support the surgical staples contained within the staple holding pockets 80, 82, and 84. The handle is at the proximal end of the elongated member 16. Drive rod 91 (FIG. 9) is operably coupled to trigger 24 of surgical sampling instrument 10 (FIG. 1) to move drive rod 91 across the staple cartridge. The sled 92 is positioned adjacent to the drive rod 91. A drive rod 91 and a sled 92 are provided for driving the disclosed surgical staples, such as surgical staple 28a, from staple pocket 80 toward staple folding pockets 74 and 76 of anvil member 50. In certain embodiments, the sled has a beveled or wedge-shaped surface for interacting with the staple pusher. As the drive rod moves across the staple cartridge, the sled moves in the same direction and pushes the staple pusher, which drives the staples from the body portion 78 against the anvil member. The sleds and pushers disclosed in US Pat. Nos. 5,762,256 and 5,865,361 can be used, the entire disclosure of which is hereby incorporated by reference.

図７および８を参照すると、初期位置では、これらの開示された外科手術用ステープルのレッグの長手方向の軸は、ステープル折り曲げポケットを通して吊り下げられているワイヤ３０に対して中心を外されている。詳細には、例えば、ステープル２８ａの第一レッグ３４の長手方向の軸ｙ−ｙは、ステープル折り曲げポケット７４（図８）の中心に対して中心は外されている。これは、形成中に第一レッグ３４がステープル折り曲げポケット７４に入り、ワイヤ３０の周りを通り抜けることを可能にする。ステープル折り曲げポケット７４のみが第一レッグ３４に対して中心を外されているように描写されるが、アンビル部材５０の全ステープル折り曲げポケットは、全ステープルレッグがステープル折り曲げポケットに入り、ワイヤ３０の周りを通り抜けることを可能にするように、ステープル折り曲げポケットの中で形成されるステープルレッグに対して中心を外されていることが理解される。   With reference to FIGS. 7 and 8, in the initial position, the longitudinal axis of the legs of these disclosed surgical staples is decentered with respect to the wire 30 suspended through the staple folding pocket. . Specifically, for example, the longitudinal axis yy of the first leg 34 of the staple 28a is decentered with respect to the center of the staple folding pocket 74 (FIG. 8). This allows the first leg 34 to enter the staple folding pocket 74 and pass around the wire 30 during formation. Although only the staple folding pocket 74 is depicted as being off-centered with respect to the first leg 34, the entire staple folding pocket of the anvil member 50 has the entire staple leg entering the staple folding pocket and around the wire 30. It is understood that it is off-centered with respect to the staple legs formed in the staple folding pocket so as to be able to pass through.

図７および図８に示されるように、最初にアンビル部材５０は、留め棒９４によりステープルカートリッジ２２に対して閉じた位置に動かされ、それによりアンビル部材５０のアンビル面５２と、ステープルカートリッジ２２のカートリッジ面９６との間に、例えば組織区分Ａおよび組織区分Ｂのような１組の組織区分を捕捉する。   As shown in FIGS. 7 and 8, the anvil member 50 is first moved to a closed position relative to the staple cartridge 22 by the retaining bar 94, thereby causing the anvil surface 52 of the anvil member 50 and the staple cartridge 22 to move. A set of tissue sections, such as tissue section A and tissue section B, is captured between the cartridge surface 96.

図９および１０をここで参照すると、アンビル部材５０がステープルカートリッジ２２に対して閉じた位置に動かされれば、外科手術用ステープル留め器具１０のトリガー２４（図１）は、ステープルカートリッジ２２内で駆動棒９２を遠位に駆動するために発動される。駆動棒９２が遠位に動くにつれ、駆動棒９２は、プッシャー８６と係合し、ステープル保持ポケット８０内で上方向にプッシャー８６を動かし、これにより第一レッグ３４および第二レッグ３６をステープル折り曲げポケット７４および７６内に駆動する。   Referring now to FIGS. 9 and 10, when the anvil member 50 is moved to a closed position relative to the staple cartridge 22, the trigger 24 (FIG. 1) of the surgical stapling instrument 10 is moved within the staple cartridge 22. Fired to drive the drive rod 92 distally. As the drive bar 92 moves distally, the drive bar 92 engages the pusher 86 and moves the pusher 86 upward within the staple holding pocket 80, thereby staple folding the first leg 34 and the second leg 36. Drive into pockets 74 and 76.

図１０に特定的に参照すると、レッグが各々のステープル折り曲げポケットに向かって駆動されるにつれ（例えば、第二レッグ３６がステープル折り曲げポケット７４に向かって駆動されるにつれ）、組織貫通先端部４０は、ステープル折り曲げポケット７４に入り、ワイヤ３０の周りを通り抜け、それにより第二レッグ３６の第二部分４８をワイヤ３０の周りに折り曲げられたまたは鉤状の構成に形成する。外科手術用ステープルのレッグを形成するこの特有の方法は、組織貫通先端部４０対して近位の第二部分４８の追加的な材料が、外科手術用ステープル２８ａをさらに固定するために、組織区分ＡおよびＢをとおして再度組織区分Ａ内に貫通することを可能にする。   Referring specifically to FIG. 10, as the legs are driven toward each staple folding pocket (eg, as the second leg 36 is driven toward the staple folding pocket 74), the tissue penetrating tip 40 is , Enters the staple folding pocket 74 and passes around the wire 30, thereby forming the second portion 48 of the second leg 36 in a folded or hooked configuration around the wire 30. This unique method of forming the legs of the surgical staple is the use of additional tissue in the second portion 48 proximal to the tissue penetrating tip 40 to further secure the surgical staple 28a. Allows penetration into tissue section A again through A and B.

図１１に最良に示されるように、組織区分ＡおよびＢは、外科手術用ステープル２８ａ、２８ｂ、２８ｃなどにより固定され、組織区分ＡおよびＢを留めることは、折り曲げられたそれぞれの外科手術用ステープルにより組織区分Ａの表面に固定されたワイヤ３０の存在によりさらに補強される。さらに注意すべきは、この特定の構成では、例えば外科手術用ステープル２８ａの第二部分４８のような折り曲げられた部分または鉤状部は、アンビル部材５０のナイフスロット５４を通り抜けるナイフの刃（図示なし）により形成される切開端ＡｃおよびＢｃに背を向けることである。   As best shown in FIG. 11, tissue sections A and B are secured by surgical staples 28a, 28b, 28c, etc., and securing tissue sections A and B is the respective folded surgical staple. Is further reinforced by the presence of the wire 30 fixed to the surface of the tissue section A. It should be further noted that in this particular configuration, a folded portion or saddle, such as the second portion 48 of the surgical staple 28a, is a knife blade (shown) that passes through the knife slot 54 of the anvil member 50. None) is turned to the incision ends Ac and Bc.

ここで図１２を参照すると、ワイヤ９８の周りに形成される複数の外科手術用ステープル１００、１０２、および１０４を有する補強部材またはワイヤ９８の別の実施形態がここに開示される。外科手術用ステープル１００は、形成された状態では、形成された状態の外科手術用ステープル１０２および１０４と同一であり、バックスパン１６から伸長する第一レッグ１０８および第二レッグ１１０を有するバックスパン１０６を概して含む。第一レッグ１０８および第二レッグ１１０は、各々の組織貫通先端部１１２および１１４で終端する。第一レッグ１０８は第一部分１１６を含み、第二レッグ１１０は第一部分１１８を含む。第一レッグ１０８は第二部分１２０を含み、第二レッグ１１０は第二部分１２２を含む。   Referring now to FIG. 12, another embodiment of a reinforcing member or wire 98 having a plurality of surgical staples 100, 102, and 104 formed around the wire 98 is disclosed herein. Surgical staple 100 in the formed state is identical to surgical staples 102 and 104 in the formed state, and backspan 106 having a first leg 108 and a second leg 110 extending from backspan 16. In general. First leg 108 and second leg 110 terminate at respective tissue penetrating tips 112 and 114. The first leg 108 includes a first portion 116 and the second leg 110 includes a first portion 118. The first leg 108 includes a second portion 120 and the second leg 110 includes a second portion 122.

示されるように、バックスパン１０６は、長手方向の軸ｘ−ｘを有し、第一レッグ１０８の第一部分１１６は、平面を画定するように、バックスパン１０６の長手方向の軸ｘ−ｘに対して直角な長手方向の軸ｙ−ｙを有する。第二レッグ１１０の第一部分１１８もバックスパン１０６対して直角であり、同平面状に位置する。示されるように、第一レッグ１０８および第二レッグ１１０の第二部分１２０および１２２は、それぞれ、バックスパン１０６、ならびに第一部分１１６および１１８により画定される平面から外側に伸長する。この特定の実施形態では、第二部分１２０および１２２は、バックスパン１０６に向かって内側に角度付けされ、バックスパン１０６の全長Ｌ１内に形成される。   As shown, the backspan 106 has a longitudinal axis xx, and the first portion 116 of the first leg 108 is on the longitudinal axis xx of the backspan 106 so as to define a plane. It has a longitudinal axis yy perpendicular to it. The first portion 118 of the second leg 110 is also perpendicular to the backspan 106 and is coplanar. As shown, the second portions 120 and 122 of the first leg 108 and the second leg 110 extend outwardly from the plane defined by the backspan 106 and the first portions 116 and 118, respectively. In this particular embodiment, the second portions 120 and 122 are angled inward toward the backspan 106 and formed within the overall length L1 of the backspan 106.

ここで図１３を参照すると、外科手術用ステープル１００を開示された構成に形成するために、アンビル面１２６を有するアンビル部材１２４の他の実施形態がここに提供される。図１および図７から１０に関して上記されたように、アンビル部材１２４は、外科手術用ステープル留め器具の一部を形成する。アンビル部材１２４は、ナイフスロット１２８、およびアンビル面のナイフスロット１２８の両側に形成されたステープル折り曲げポケットの列１３０および１３２を含む。この明細書の以前の部分で記述されたアンビル部材５０と同様に、アンビル部材１２４は、アンビル面１２６、ならびにステープル折り曲げポケット１３０および１３２の列にわたって伸長する１組のチャネル１３４および１３６を含む。チャネル１３４および１３６は、ワイヤ３０に関連してこの明細書の以前の部分に実質的に記述された態様で補強部材またはワイヤ９８を保持するために提供される。   Referring now to FIG. 13, another embodiment of an anvil member 124 having an anvil surface 126 is provided herein to form surgical staple 100 in the disclosed configuration. As described above with respect to FIGS. 1 and 7-10, the anvil member 124 forms part of a surgical stapling instrument. Anvil member 124 includes a knife slot 128 and rows 130 and 132 of staple folding pockets formed on opposite sides of knife slot 128 on the anvil surface. Similar to the anvil member 50 described earlier in this specification, the anvil member 124 includes an anvil surface 126 and a set of channels 134 and 136 that extend across the rows of staple folding pockets 130 and 132. Channels 134 and 136 are provided to hold the reinforcing member or wire 98 in a manner substantially as described earlier in this specification in connection with wire 30.

第二部分１２０および１２２を、バックスパン１０６に向かって内側に向けられるそれぞれの折り曲げられた構成に形成するために、ステープル折り曲げポケットの列１３０は、第一ステープル折り曲げポケット１３８および第二ステープル折り曲げポケット１４０を含む。示されるように、第一ステープル折り曲げポケット１３８は、軸Ｃ−Ｃを有し、第二ステープル折り曲げポケット１４０は、軸Ｄ−Ｄを有し、両軸は、ナイフスロット１２８に向かって収束し、アンビル部材１２４の長手方向の軸Ｅ−Ｅに対して９０°でない角度に配向される。注意すべきは、以前の実施形態とは違って、ステープル折り曲げポケット１３８および１４０は、形成の際に、外科手術用ステープル１００の折り曲げられた第二部分１２０および１２２が内側に角度付けされ、ナイフスロット１２８を通り抜けるナイフの刃（図示なし）により切開された組織の端の方を向くように、ナイフスロット１２８に向かって内側に角度付けされることである。   In order to form the second portions 120 and 122 in respective folded configurations directed inwardly toward the backspan 106, the staple fold pocket row 130 comprises a first staple fold pocket 138 and a second staple fold pocket. 140 is included. As shown, the first staple folding pocket 138 has an axis C-C, the second staple folding pocket 140 has an axis DD, and both axes converge toward the knife slot 128; It is oriented at an angle that is not 90 ° with respect to the longitudinal axis EE of the anvil member 124. It should be noted that, unlike the previous embodiment, the staple folding pockets 138 and 140 are angled inwardly when the folded second portions 120 and 122 of the surgical staple 100 are formed, as the knife is formed. It is angled inward toward the knife slot 128 so that it faces toward the end of the incised tissue by a knife blade (not shown) that passes through the slot 128.

図１４を参照にして、ワイヤ１４２の周りに形成される複数のステープル１４４、１４６、および１４８を有する補強部材またはワイヤ１４２の別の実施形態がここに開示される。以前の一連のステープルのように、外科手術用ステープル１４４は、形成された状態では、外科手術用ステープル１４６および１４８と同一であり、バックスパン１５０を含み、第一レッグ１５２および第二レッグ１５４はバックスパンから伸長し、それぞれの組織貫通先端部１５６および１５８で終端する。第一レッグ１５２は第一部分１６０を含み、第二レッグ１５４は第一部分１６２を含む。以前の実施形態と同様に、第一レッグ１５２は第二部分１６４を含み、第二レッグ１５４は第二部分１６６を含む。   Referring to FIG. 14, another embodiment of a reinforcing member or wire 142 having a plurality of staples 144, 146, and 148 formed around the wire 142 is disclosed herein. Like the previous series of staples, the surgical staple 144 is identical to the surgical staples 146 and 148 in the formed state and includes a backspan 150, the first leg 152 and the second leg 154 being Extends from the backspan and terminates at respective tissue penetrating tips 156 and 158. The first leg 152 includes a first portion 160 and the second leg 154 includes a first portion 162. Similar to the previous embodiment, the first leg 152 includes a second portion 164 and the second leg 154 includes a second portion 166.

バックスパン１５０は、長手方向の軸ｘ−ｘを有し、第一レッグ１５２の第一部分１６０は、平面を画定するように、バックスパン１５０の長手方向の軸ｘ−ｘに対して直角な長手方向の軸ｙ−ｙを有する。第二レッグ１５４の第一部分１６２もバックスパン１５０に対し直角であり、平面内に位置する。示されるように、第一レッグ１５２および第二レッグ１５４の第二部分１６４および１６６は、それぞれ、バックスパン１５０、ならびに第一部分１６０および１６２により画定される平面の外側に伸長する。この特定の実施形態では、第二部分１６４および１６６は、互いに平行であり、バックスパン１５０の長手方向の軸ｘ−ｘに対して９０°でない角度を形成する。   The backspan 150 has a longitudinal axis xx, and the first portion 160 of the first leg 152 is longitudinally perpendicular to the longitudinal axis xx of the backspan 150 so as to define a plane. It has a direction axis y-y. The first portion 162 of the second leg 154 is also perpendicular to the backspan 150 and lies in the plane. As shown, the second portions 164 and 166 of the first leg 152 and the second leg 154 extend outside the plane defined by the backspan 150 and the first portions 160 and 162, respectively. In this particular embodiment, the second portions 164 and 166 are parallel to each other and form an angle that is not 90 ° with respect to the longitudinal axis xx of the backspan 150.

図１５を参照すると、外科手術用ステープル１４４を開示された構成に形成するために、アンビル面１７０を有するアンビル部材１６８のさらなる他の実施形態がここに提供される。アンビル部材１６８は、図１および図７−１０に関して上記されたように、外科手術用ステープル留め器具の一部を形成する。アンビル部材１６８は、アンビル部材１６８、およびナイフスロット１７２の両側に形成されるステープル折り曲げポケットの列１７４および１７６の実質的に全長に伸長するナイフスロット１７２を含む。アンビル部材１６８は、ワイヤ３０に関連してこの明細書の以前の部分で記述された態様でワイヤ１４２を一時的に固定するために、アンビル面１７０、およびステープル折り曲げポケット１７４および１７６の列にわたって伸長するチャネル１７８および１８０を追加的に含む。   Referring to FIG. 15, yet another embodiment of an anvil member 168 having an anvil surface 170 is provided herein to form surgical staple 144 in the disclosed configuration. Anvil member 168 forms part of a surgical stapling instrument as described above with respect to FIGS. 1 and 7-10. Anvil member 168 includes an anvil member 168 and a knife slot 172 that extends substantially the entire length of rows of staple folding pockets 174 and 176 formed on opposite sides of knife slot 172. Anvil member 168 extends across the anvil surface 170 and the rows of staple folding pockets 174 and 176 to temporarily secure the wire 142 in the manner described earlier in this specification with respect to the wire 30. Additional channels 178 and 180 are included.

第二部分分１６４および１６２を、バックスパン１５０に対して角度付けされ並行なそれらの折り曲げられた構成に形成するために、ステープル折り曲げポケットの列１７４は、第一ステープル折り曲げポケット１８２および第二ステープル折り曲げポケット１８４を含む。第一ステープル折り曲げポケット１８２は、第二ステープル折り曲げポケット１８４の長手方向の軸Ｇ−Ｇに対して平行な長手方向の軸Ｆ−Ｆを有する。第一ステープル折り曲げポケット１８２および第二ステープル折り曲げポケット１８４の両方は、アンビル部材１６８の長手方向の軸Ｈ−Ｈに対して角度を形成する。   In order to form the second portions 164 and 162 in their folded configuration that is angled and parallel to the backspan 150, the row of staple folding pockets 174 includes the first staple folding pocket 182 and the second staple. A folding pocket 184 is included. The first staple folding pocket 182 has a longitudinal axis FF that is parallel to the longitudinal axis GG of the second staple folding pocket 184. Both the first staple folding pocket 182 and the second staple folding pocket 184 form an angle with respect to the longitudinal axis HH of the anvil member 168.

ここで図１６を参照すると、補強ワイヤ１８６の周りに形成される外科手術用ステープル１８８、１９０、および１９２を有する補強部材またはワイヤ１８６のさらなる実施形態がここに開示される。外科手術用ステープル１８８は、外科手術用ステープル１９０および１９２と同一であり、バックスパン１９４から伸長する第一レッグ１９６および第二レッグ１９８を有するバックスパン１９４を概して含む。組織貫通先端部２００および２０２が第一レッグ１９６および第二レッグ１９８にそれぞれ形成される。第一レッグ１９６および第二レッグ１９８は、それぞれ第一部分２０４および２０６、ならびに、それぞれ第二部分２０８および２１０を含む。第一レッグ１９６の第一部分２０４は、バックスパン１９４の長手方向の軸ｘ−ｘに対して直角であり、長手方向の軸ｘ−ｘとの間で平面を画定する長手方向の軸ｙ−ｙを有する。以前の実施形態のように、形成された状態では、第二部分２０８および２１０は、第一部分２０４およびバックスパン１９４により画定された平面を越えて伸長する。   Referring now to FIG. 16, a further embodiment of a reinforcing member or wire 186 having surgical staples 188, 190, and 192 formed around the reinforcing wire 186 is now disclosed. Surgical staple 188 is identical to surgical staples 190 and 192 and generally includes a backspan 194 having a first leg 196 and a second leg 198 extending from backspan 194. Tissue penetrating tips 200 and 202 are formed in the first leg 196 and the second leg 198, respectively. First leg 196 and second leg 198 include first portions 204 and 206, respectively, and second portions 208 and 210, respectively. The first portion 204 of the first leg 196 is perpendicular to the longitudinal axis xx of the backspan 194 and defines a longitudinal axis yy that defines a plane with the longitudinal axis xx. Have As in the previous embodiment, in the formed state, the second portions 208 and 210 extend beyond the plane defined by the first portion 204 and the backspan 194.

この特定の実施形態では、第二部分２０８および２１０は、それらがバックスパン１９４の全長Ｌ２を超えて伸長するようにバックスパン１９４に対して外側に角度付けまたは斜角付けされる。   In this particular embodiment, the second portions 208 and 210 are angled or beveled outward with respect to the backspan 194 such that they extend beyond the entire length L2 of the backspan 194.

外科手術用ステープル１８８、１９０、および１９２をそれらの開示された構成に形成するために、アンビル面２１４を有するアンビル部材２１２（図１７）がここに提供される。アンビル部材２１２は、図１および図７から１０に関して上記されたように、外科手術用ステープル留め器具の一部を形成する。アンビル部材２１２は、長手方向に伸長するナイフスロット２１６、およびアンビル面２１４のナイフスロット２１６の両側に形成されたステープル折り曲げポケットの列２１８および２２０を含む。１組のチャネル２２２および２２４が、ワイヤ１８６を保持するために、アンビル面２１４にわたって、ステープル折り曲げポケット２１８および２２０をとおして提供される。   An anvil member 212 (FIG. 17) having an anvil surface 214 is provided herein to form surgical staples 188, 190, and 192 in their disclosed configurations. Anvil member 212 forms part of a surgical stapling instrument as described above with respect to FIGS. 1 and 7-10. Anvil member 212 includes a longitudinally extending knife slot 216 and rows of staple folding pockets 218 and 220 formed on opposite sides of knife slot 216 on anvil surface 214. A set of channels 222 and 224 are provided through the staple folding pockets 218 and 220 over the anvil surface 214 to hold the wire 186.

ステープル折り曲げポケットの列２１８は、第一ステープル折り曲げポケット２２６および第二ステープル折り曲げポケット２２８を含む。第一ステープル折り曲げポケット２２６は長手方向の軸Ｉ−Ｉを有し、第二ステープル折り曲げポケット２２８は長手方向の軸Ｊ−Ｊを有し、両軸は、ナイフスロット２１６から離れて収束し、アンビル部材２１２の長手方向の軸Ｋ−Ｋに対して９０°でない角度で方向付けされる。   The staple fold pocket row 218 includes a first staple fold pocket 226 and a second staple fold pocket 228. The first staple folding pocket 226 has a longitudinal axis II, the second staple folding pocket 228 has a longitudinal axis JJ, both axes converge away from the knife slot 216, and anvil Oriented at a non-90 ° angle with respect to the longitudinal axis KK of member 212.

図１８を参照すると、補強材料またはワイヤの周りに開示された外科手術用ステープルを形成することへの使用に対し適当なアンビル部材２３０のさらなる他の実施形態がここに開示される。アンビル部材２３０は、図１および図７から１０に関して上記されたように、外科手術用ステープル留め器具の一部を形成する。アンビル部材２３０は、アンビル部材２３０にわたって長手方向に伸長するナイフスロット２３４を有するアンビル面２３２を含む。ステープル折り曲げポケットの列２３６、２３８、２４０、および２４２がナイフスロット２３４に並んで提供される。以前のアンビル実施形態のように、長手方向に伸長するチャネル２４４、２４６、２４８、および２５０は、例えばステープルポケット２５２および２５４のようなステープルポケットにわたって補強部材の全長をリムーバブルに支持するように、ステープル折り曲げポケットの列２３６、２３８、２４０、および２４２を通して伸長する。注意すべきは、この開示されたアンビル部材の他の実施形態、および以前に開示されたアンビル部材の他の実施形態では、ステープルポケット２５２および２５４は、以前に開示された任意の構成および配向を取り得ることである。例えば、アンビル部材２３０の全てのステープルポケット２５２および２５４は、同じまたは異なる方向に配向され得る。   Referring to FIG. 18, yet another embodiment of an anvil member 230 suitable for use in forming the disclosed surgical staples around a reinforcing material or wire is disclosed herein. Anvil member 230 forms part of a surgical stapling instrument, as described above with respect to FIGS. 1 and 7-10. Anvil member 230 includes an anvil surface 232 having a knife slot 234 extending longitudinally across anvil member 230. A row of staple folding pockets 236, 238, 240, and 242 are provided alongside the knife slot 234. As in previous anvil embodiments, the longitudinally extending channels 244, 246, 248, and 250 are stapled so that the full length of the reinforcing member is removablely supported across staple pockets, such as staple pockets 252 and 254, for example. It extends through the rows of folding pockets 236, 238, 240, and 242. It should be noted that in other embodiments of this disclosed anvil member, and in other embodiments of previously disclosed anvil members, staple pockets 252 and 254 have any previously disclosed configuration and orientation. It is possible. For example, all staple pockets 252 and 254 of anvil member 230 can be oriented in the same or different directions.

図２から６および図１１から１８に関して上記されたように、１つ以上の補強部材およびステープルを有するファスナーアセンブリは、円状または弓状のアンビルを有する外科手術用ステープル留め器具、および／またはアンビル（またはカートリッジ）が組織を留めるために動く同じ方向にステープルがアンビルに対して駆動される外科手術用ステープル留め器具に使用され得ることが考えられる。   As described above with respect to FIGS. 2-6 and FIGS. 11-18, a fastener assembly having one or more reinforcing members and staples is a surgical stapling instrument having a circular or arcuate anvil, and / or an anvil. It is contemplated that the (or cartridge) can be used in a surgical stapling instrument where the staples are driven relative to the anvil in the same direction that they move to clamp the tissue.

この明細書に開示された実施形態に様々な改変がされ得ることが理解される。例えば、開示されたステープル折り曲げポケットは、例えば円状、８の字型などのような楕円形でない形状を取り得る。さらに、この明細書の以前の部分で示されたように、それぞれの１節の補強材料が開示されたステープル折り曲げポケットを完全に妨げない限り、開示された補強部材は、例えばウェビング材料の細片、金属または重合体の平坦なリボンなどのようなワイヤでない材料を含み得る。そのため、上記は、制限的に解釈されるものではない。当事者はここに添付される特許請求の範囲および精神を逸脱しない他の改変を想像する。   It will be understood that various modifications may be made to the embodiments disclosed in this specification. For example, the disclosed staple folding pocket may take a non-elliptical shape, such as a circle, figure eight, and the like. Further, as indicated in the previous part of this specification, the disclosed reinforcing member may be a strip of webbing material, for example, unless each section of reinforcing material completely obstructs the disclosed staple folding pocket. , Non-wire materials such as metal or polymeric flat ribbons and the like. Therefore, the above is not interpreted restrictively. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

１０ 外科手術用サンプリング器具
１２ アンビルアセンブリ
１４ ハンドル
１６ 細長い筒状部材
１８ エンドエフェクタ
２２ ステープルカートリッジ
２４ トリガー
２６ 回転ノブ DESCRIPTION OF SYMBOLS 10 Surgical sampling instrument 12 Anvil assembly 14 Handle 16 Elongated cylindrical member 18 End effector 22 Staple cartridge 24 Trigger 26 Rotation knob

Claims (29)

長手方向の軸、第一ステープル折り曲げポケット、および第二ステープル折り曲げポケットを有するアンビル部材と、
該第一ステープル折り曲げポケットおよび該第二ステープル折り曲げポケットにわたって伸長する一本の補強部材と
を含み、該補強部材の幅は、該第一ステープル折り曲げポケットおよび該第二ステープル折り曲げポケットの幅よりも狭い、外科手術用ステープル留め器具との使用のためのアンビルアセンブリ。 An anvil member having a longitudinal axis, a first staple folding pocket, and a second staple folding pocket;
A reinforcing member extending across the first staple folding pocket and the second staple folding pocket, wherein the width of the reinforcing member is narrower than the width of the first staple folding pocket and the second staple folding pocket An anvil assembly for use with a surgical stapling instrument. 前記第一ステープル折り曲げポケットおよび前記第二ステープル折り曲げポケットのそれぞれは、楕円形状であり、前記アンビル部材の長手方向の軸に対して角度をもって形成される長手方向の軸を有する、請求項１に記載のアンビルアセンブリ。 The first staple folding pocket and the second staple folding pocket are each elliptical and have a longitudinal axis formed at an angle with respect to the longitudinal axis of the anvil member. Anvil assembly. 前記第一ステープル折り曲げポケットの長手方向の軸と前記第二ステープル折り曲げポケットの長手方向の軸は、互いに平行である、請求項２に記載のアンビルアセンブリ。 The anvil assembly according to claim 2, wherein the longitudinal axis of the first staple folding pocket and the longitudinal axis of the second staple folding pocket are parallel to each other. 前記第一ステープル折り曲げポケットの長手方向の軸と前記第二ステープル折り曲げポケットの長手方向の軸とは、前記アンビル部材の長手方向の軸に対して直角である、請求項２に記載のアンビルアセンブリ。 The anvil assembly of claim 2, wherein the longitudinal axis of the first staple folding pocket and the longitudinal axis of the second staple folding pocket are perpendicular to the longitudinal axis of the anvil member. 前記第一ステープル折り曲げポケット長手方向の軸と前記第二ステープル折り曲げポケットの長手方向の軸とは、前記アンビル部材の長手方向の軸に向かって収束する、請求項２に記載のアンビルアセンブリ。 The anvil assembly of claim 2, wherein the longitudinal axis of the first staple folding pocket and the longitudinal axis of the second staple folding pocket converge toward the longitudinal axis of the anvil member. 前記第一ステープル折り曲げポケットの長手方向の軸と前記第二ステープル折り曲げポケットの長手方向の軸とは、前記アンビル部材の長手方向の軸から離れて広がる、請求項２に記載のアンビルアセンブリ。 The anvil assembly according to claim 2, wherein a longitudinal axis of the first staple folding pocket and a longitudinal axis of the second staple folding pocket extend away from a longitudinal axis of the anvil member. 前記アンビル部材は、前記補強部材の受け入れのための長手方向のトラフを含み、該長手方向のトラフは、前記第一ステープル折り曲げポケットおよび前記第二ステープル折り曲げポケットにわたって伸長する、請求項１に記載のアンビルアセンブリ。 The said anvil member includes a longitudinal trough for receiving said reinforcing member, and said longitudinal trough extends across said first staple folding pocket and said second staple folding pocket. Anvil assembly. 前記トラフは、前記補強部材の幅よりも狭い幅を有する開きを有する、請求項７に記載のアンビルアセンブリ。 The anvil assembly of claim 7, wherein the trough has an aperture having a width that is narrower than a width of the reinforcing member. 前記長手方向のトラフは、前記第一ステープル折り曲げポケットおよび前記第二ステープル折り曲げポケットにわたって前記補強部材を吊り下げる、請求項７に記載のアンビルアセンブリ。 The anvil assembly of claim 7, wherein the longitudinal trough suspends the reinforcement member across the first staple fold pocket and the second staple fold pocket. 長手方向の軸を有するバックスパンと、
該バックスパンから伸長する第一レッグと、
該バックスパンから伸長する第二レッグと
を含み、該第一レッグおよび該第二レッグのそれぞれは、組織貫通先端部で終端し、該第一レッグは、該バックスパンの長手方向の軸と平面を画定する長手方向の軸を有する第一部分、および該バックスパンの長手方向の軸と該第一部分とにより画定される該平面の外側に突出する第二部分を含む、完全に形成された外科手術用ステープル。 A backspan having a longitudinal axis;
A first leg extending from the backspan;
A second leg extending from the backspan, each of the first leg and the second leg terminating at a tissue penetrating tip, wherein the first leg is planar with a longitudinal axis of the backspan. A fully formed surgical procedure comprising a first portion having a longitudinal axis defining a longitudinal axis and a second portion projecting out of the plane defined by the longitudinal axis of the backspan and the first portion For staples. 前記第二部分は鉤形状を有する、請求項１０に記載の完全に形成された外科手術用ステープル。 The fully formed surgical staple according to claim 10, wherein the second portion has a saddle shape. 前記第二レッグは、前記バックスパンから伸長し、前記平面内に位置する第一部分、および該第一部分から伸長し、該平面の外側に突出する第二部分を含む、請求項１１に記載の完全に形成された外科手術用ステープル。 12. The complete of claim 11, wherein the second leg includes a first portion extending from the backspan and located in the plane and a second portion extending from the first portion and projecting outside the plane. Surgical staples formed into. 前記第一レッグの第二部分、および前記第二レッグの第二部分は、互いに平行である、請求項１２に記載の完全に形成された外科手術用ステープル。 The fully formed surgical staple according to claim 12, wherein the second portion of the first leg and the second portion of the second leg are parallel to each other. 前記第一レッグの第二部分、および前記第二レッグの第二部分は、前記バックスパンの長手方向の軸に対して直角である、請求項１３に記載の完全に形成された外科手術用ステープル。 14. A fully formed surgical staple according to claim 13, wherein the second portion of the first leg and the second portion of the second leg are perpendicular to the longitudinal axis of the backspan. . 前記第一レッグの第二部分、および前記第二レッグの第二部分は、互いに向かって内側に収束し、前記バックスパンの長さ内にある、請求項１２に記載の完全に形成された外科手術用ステープル。 The fully formed surgical of claim 12, wherein the second portion of the first leg and the second portion of the second leg converge inward toward each other and are within the length of the backspan. Surgical staples. 前記第一レッグの第二部分、および前記第二レッグの第二部分は、互いから離れて広がり、前記バックスパンの長さを超えて伸長する、請求項１２に記載の完全に形成された外科手術用ステープル。 The fully formed surgical of claim 12, wherein the second portion of the first leg and the second portion of the second leg extend away from each other and extend beyond the length of the backspan. Surgical staples. 細長い部材と、
該細長い部材の近位端にあるハンドルアセンブリと、
該細長い部材の遠位端にあるエンドエフェクタと
を含み、該エンドエフェクタは、請求項１に従ったアンビルアセンブリと、ステープルカートリッジとを含み、該アンビルアセンブリおよび該ステープルカートリッジは、互いに対して可動的である、外科手術用ステープル留め器具。 An elongated member;
A handle assembly at a proximal end of the elongated member;
An end effector at a distal end of the elongate member, the end effector comprising an anvil assembly according to claim 1 and a staple cartridge, wherein the anvil assembly and the staple cartridge are movable relative to each other. A surgical stapling instrument. 前記アンビル部材は、前記補強部材の受け入れのための長手方向のトラフを含む、請求項１７に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 17, wherein the anvil member includes a longitudinal trough for receipt of the reinforcing member. 前記長手方向のトラフは、第一ステープル折り曲げポケットおよび第二ステープル折り曲げポケットにわたって伸長する、請求項１８に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 18, wherein the longitudinal trough extends across a first staple folding pocket and a second staple folding pocket. 前記トラフは、前記補強部材の幅よりも狭い幅の開きを有する、請求項１８に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 18, wherein the trough has an opening that is narrower than a width of the reinforcing member. 前記長手方向のトラフは、前記第一ステープル折り曲げポケットおよび前記第二ステープル折り曲げポケットにわたって前記補強部材を吊り下げる、請求項１８に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 18, wherein the longitudinal trough suspends the reinforcing member across the first staple folding pocket and the second staple folding pocket. 前記ステープルカートリッジは、複数のステープル保持ポケットを伴う本体部分を有する、請求項１７に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 17, wherein the staple cartridge has a body portion with a plurality of staple retaining pockets. 前記ステープル保持ポケットは、それぞれ、ステープルを含む、請求項２２に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 22, wherein each of the staple retaining pockets includes a staple. 前記ハンドルアセンブリに動作的に関連する駆動棒をさらに含む、請求項１７に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 17, further comprising a drive rod operatively associated with the handle assembly. 前記ハンドルアセンブリはトリガーを含む、請求項２４に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 24, wherein the handle assembly includes a trigger. 前記ステープルカートリッジは、そりを有する、請求項２２に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 22, wherein the staple cartridge has a sled. 前記補強部材は、ワイヤ、縫合糸、または材料片から成るグループから選択される、請求項１７に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 17, wherein the reinforcing member is selected from the group consisting of a wire, a suture, or a piece of material. 前記補強部材の長さは、２つより多くのステープル折り曲げポケットにわたって伸長する、請求項１７に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 17, wherein the length of the reinforcing member extends over more than two staple folding pockets. 前記アンビル部材は、円状アンビル部材および弓状アンビル部材から成るグループから選択される、請求項１７に記載の外科手術用ステープル留め器具。 The surgical stapling instrument according to claim 17, wherein the anvil member is selected from the group consisting of a circular anvil member and an arcuate anvil member.
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